加速康复外科在老年转子间骨折围手术期运用的临床疗效

Clinical Effect of Enhanced Recovery After Surgery in the Perioperative Period of Intertrochanteric Fracture in Elderly Patients

目的观察老年转子间骨折患者围手术期运用加速康复外科(ERAS)理念的临床疗效。方法选取2020年8月至2023年5月于我院手术的股骨转子间骨折患者79例。按照实施ERAS前后分为对照组和观察组,观察组39例围手术期行ERAS,对照组40例行传统创伤骨科治疗康复。对比两组的疼痛视觉模拟评分(visual analogue scale VAS)、早期并发症发生率、术后首次下地时间、住院时间、髋关节Harris评分差异。结果观察组术后1、3、7 d的VAS评分低于对照组(P<0.05)。观察组术后早期并发症发生率低于对照组(P<0.05)。观察组术后首次下地时间和住院天数短于对照组(P<0.05)。观察组术后7 d、1个月、3个月的Harris评分高于对照组(P<0.05)。结论在老年转子间骨折围手术期运用ERAS能减轻患者疼痛程度,并且能更早下地活动,更快改善髋关节功能,减少住院时间及术后早期并发症,值得临床应用。

Objective To observe the clinical efficacy of the perioperative use of accelerated rehabilitation surgery(ERAS)concept in elderly intertrochanteric fracture patients.Methods A total of 79 patients with intertrochanteric fractures of the femur operated in our hospital from August 2020 to May 2023 were selected.They were divided into a control group and an observation group before and after the implementation of ERAS.39 cases in the observation group underwent ERAS in the perioperative period,and 40 cases in the control group underwent traditional trauma orthopaedic treatment and rehabilitation.The differences in pain visual analogue scale(VAS),early complication rate,postoperative first time to the ground,hospital stay,and hip Harris score were compared between the two groups.Results The VAS scores of the observation group were lower than those of the control group at 1,3,and 7 d postoperatively(P<0.05).The incidence of early postoperative complications in the observation group was lower than that in the control group(P<0.05).The first postoperative time to get down to the ground and the number of hospitalisation days were shorter in the observation group than in the control group(P<0.05).The Harris scores at 7 d,1 month,and 3 months postoperatively in the observation group were higher than those in the control group(P<0.05).Conclusions The use of ERAS in the perioperative period of intertrochanteric fracture in the elderly can reduce the degree of pain of the patients,and can get down to the ground earlier,improve the function of the hip joint faster,reduce the length of hospitalisation and early postoperative complications,which is worthy of clinical application.